Individual
DANIEL DE JESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
85 SEYMOUR ST, SUITE 200, HARTFORD, CT 06106-5501
(860) 289-3375
(860) 783-5733
Mailing address
134 GRANDVIEW AVE, SUITE 101, WATERBURY, CT 06708-2507
(203) 756-8911
(203) 574-0548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000848
CT
Other
Enumeration date
11/17/2005
Last updated
04/15/2015
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